Cost of vascular access devices in public hospitals in Queensland
Haitham W. Tuffaha A B , Nicole Marsh C D E , Joshua Byrnes B , Nicole Gavin C D E , Joan Webster C D E , Marie Cooke D E and Claire M. Rickard C D EA Menzies Health Institute Queensland, Griffith University, Qld 4111, Australia. Email: Haitham.tuffaha@griffith.edu.au
B Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University, Qld 4111, Australia. Email: j.byrnes@griffith.edu.au
C Nursing and Midwifery Research Centre, Royal Brisbane and Women’s Hospital, Herston, Qld 4006, Australia. Email: nicole.marsh@health.qld.gov.au; nicole.gavin@health.qld.gov.au
D Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia. Email: m.cooke@griffith.edu.au; c.rickard@griffith.edu.au
E School of Nursing and Midwifery, Griffith University, Nathan Qld 4111, Australia.
F Corresponding author. Email: joan.webster@heath.qld.gov.au
Australian Health Review 43(5) 511-515 https://doi.org/10.1071/AH18102
Submitted: 12 December 2017 Accepted: 31 July 2018 Published: 4 September 2018
Abstract
Objective The aim of this study was to quantify the utilisation of vascular access devices in Queensland public hospitals and their associated cost.
Methods Devices were broadly classified into peripheral intravenous catheters, central venous catheters and arterial lines. The number of catheters used was obtained from a central procurement department at Queensland Health and validated using Medicare Benefits Schedule (MBS) claims and/or hospital data from the Australian Institute of Health and Welfare for the same period. Resources consumed included equipment and staff time required to insert and remove catheters. Equipment costs were valued using negotiated hospital prices, and staff time was valued at the fixed industrial award wages in Australia or relevant MBS fees. Device maintenance costs (e.g. dressings) and costs of treating complications were excluded.
Results Approximately 2.75 million vascular access devices were used in public hospitals in Queensland in 2016, at a total cost of A$59.14 million. This comprised a total equipment cost of around A$10.17 million and a total labour cost of A$48.85 million
Conclusion Vascular access is an important component of healthcare expenditure. The present study is the first to characterise and cost vascular access devices in Queensland. Further research is needed on the costs of maintaining device function and of treating complications associated with vascular access.
What is known about the topic? The cost of vascular access in Australia has previously been estimated from modelling, using various assumptions, or based on device utilisation in other countries.
What does this paper add? For the first time, device utilisation for vascular access in Queensland has been quantified and costed. Results were obtained from reliable sources and validated against other databases.
What are the implications for practitioners? Practitioners and managers may now provide accurate estimates about the cost of catheter failure, a potentially preventable problem that affects up to 50% of all catheters placed. Attaching costs to such failure may also stimulate research into how to reduce the problem.
Additional keywords: economic evaluation, equipment costs, intravenous catheterisation, staff costs.
References
[1] Biffi R. History of vascular access. In: Di Carlo I, Biffi R, editors. Totally implantable vascular access devices. Milan: Springer-Verlag; 2012. pp. 3–9.[2] Millam D. The history of intravenous therapy. J Intraven Nurs 1996; 19 5–14.
[3] Rivera AM, Strauss KW, van Zundert A, Mortier E. The history of peripheral intravenous catheters: how little plastic tubes revolutionized medicine. Acta Anaesthesiol Belg 2005; 56 271–82.
[4] Duffy BJ. The clinical use of polyethylene tubing for intravenous therapy; a report on 72 cases. Ann Surg 1949; 130 929–36.
| The clinical use of polyethylene tubing for intravenous therapy; a report on 72 cases.Crossref | GoogleScholarGoogle Scholar |
[5] Hord JD, Lawlor J, Werner E, Billett AL, Bundy DG, Winkle C, Gaur AH. Central line associated blood stream infections in pediatric hematology/oncology patients with different types of central lines. Pediatr Blood Cancer 2016; 63 1603–7.
| Central line associated blood stream infections in pediatric hematology/oncology patients with different types of central lines.Crossref | GoogleScholarGoogle Scholar |
[6] Adams DZ, Little A, Vinsant C, Khandelwal S. The midline catheter: a clinical review. J Emerg Med 2016; 51 252–8.
| The midline catheter: a clinical review.Crossref | GoogleScholarGoogle Scholar |
[7] Marsh N, Webster J, Larsen E, Cooke M, Mihala G, Rickard C. Observational study of peripheral intravenous catheter outcomes in adult hospitalized patients: a multivariate analysis of peripheral intravenous catheter failure. J Hosp Med 2018; 13 83–9.
| Observational study of peripheral intravenous catheter outcomes in adult hospitalized patients: a multivariate analysis of peripheral intravenous catheter failure.Crossref | GoogleScholarGoogle Scholar |
[8] Kang J, Chen W, Sun W, Ge R, Li H, Ma E, Su Q, Cheng F, Hong J, Zhang Y, Lei C, Wang X, Jin A, Liu W. Peripherally inserted central catheter-related complications in cancer patients: a prospective study of over 50,000 catheter days. J Vasc Access 2017; 18 153–7.
| Peripherally inserted central catheter-related complications in cancer patients: a prospective study of over 50,000 catheter days.Crossref | GoogleScholarGoogle Scholar |
[9] Miliani K, Taravella R, Thillard D, Chauvin V, Martin E, Edouard S, Astagneau P, CATHEVAL Study Group Peripheral venous catheter-related adverse events: evaluation from a multicentre epidemiological study in France (the CATHEVAL Project). PLoS One 2017; 12
| Peripheral venous catheter-related adverse events: evaluation from a multicentre epidemiological study in France (the CATHEVAL Project).Crossref | GoogleScholarGoogle Scholar |
[10] Rickard CM, Marsh N, Webster J, Playford EG, McGrail MR, Larsen E, Keogh S, McMillan D, Whitty JA, Choudhury MA, Dunster KR, Reynolds H, Marshall A, Crilly J, Young J, Thom O, Gowardman J, Corley A, Fraser JF. Securing All intraVenous devices Effectively in hospitalised patients – the SAVE trial: study protocol for a multicentre randomised controlled trial. BMJ Open 2015; 5
| Securing All intraVenous devices Effectively in hospitalised patients – the SAVE trial: study protocol for a multicentre randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
[11] Société Française d’Hygiène Hospitalière (SFHH), Haute Autorité de Santé. Prévention des infections liées aux cathéters veineux périphériques. Recommandations pour la pratique clinique [Prevention of peripheral venous catheter-related infections. Guidelines for clinical practice]. 2005. Available at: https://sf2h.net/wp-content/uploads/2005/11/SF2H_prevention-infections-catheters-veineux-peripheriques-2005.pdf [verified 23 October 2017].
[12] Hadaway L. Short peripheral intravenous catheters and infections. J Infus Nurs 2012; 35 230–40.
| Short peripheral intravenous catheters and infections.Crossref | GoogleScholarGoogle Scholar |
[13] Becerra MB, Shirley D, Safdar N. Prevalence, risk factors, and outcomes of idle intravenous catheters: an integrative review. Am J Infect Control 2016; 44 e167–72.
| Prevalence, risk factors, and outcomes of idle intravenous catheters: an integrative review.Crossref | GoogleScholarGoogle Scholar |
[14] Fields JM, Piela NE, Au AK, Ku BS. Risk factors associated with difficult venous access in adult ED patients. Am J Emerg Med 2014; 32 1179–82.
| Risk factors associated with difficult venous access in adult ED patients.Crossref | GoogleScholarGoogle Scholar |
[15] Tuffaha HW, Rickard CM, Webster J, Marsh N, Gordon L, Wallis M, Scuffham P. Cost-effectiveness analysis of clinically indicated versus routine replacement of peripheral intravenous catheters. Appl Health Econ Health Policy 2014; 12 51–8.
| Cost-effectiveness analysis of clinically indicated versus routine replacement of peripheral intravenous catheters.Crossref | GoogleScholarGoogle Scholar |
[16] Australian Institute of Health and Welfare (AIHW). Australia’s hospitals 2014–15 at a glance. Canberra: AIHW; 2016. Available at: https://www.aihw.gov.au/reports/hospitals/australias-hospitals-2014-15-at-a-glance/contents/admitted-patient-care [verified 23 August 2017].
[17] Medicare Australia. Medicare item reports. Available at: http://medicarestatistics.humanservices.gov.au/statistics/mbs_item.jsp [verified 23 August 2017].
[18] Ullman AJ, Marsh N, Mihala G, Cooke M, Rickard CM. Complications of central venous access devices: a systematic review. Pediatrics 2015; 136 e1331–44.
[19] Helm RE, Klausner J, Klemperer J, Flint L, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs 2015; 38 189–203.
| Accepted but unacceptable: peripheral IV catheter failure.Crossref | GoogleScholarGoogle Scholar |
[20] Chopra V, Flanders SA, Saint S, Woller SC, O’Grady NP, Safdar N, Trerotola SO, Saran R, Moureau N, Wiseman S, Pittiruti M, Akl EA, Lee AY, Courey A, Swaminathan L, LeDonne J, Becker C, Krein SL, Bernstein SJ, Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) Panel The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Intern Med 2015; 163 S1–40.
| The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness method.Crossref | GoogleScholarGoogle Scholar |
[21] Australian Institute of Health and Welfare (AIHW). Admitted patient care 2015–16: Australian hospital statistics. Canberra: AIHW; 2017. Available at: https://www.aihw.gov.au/reports/hospitals/ahs-2015-16-admitted-patient-care/contents/table-of-contents [verified 14 August 2018].
